Shortly after Viagra was approved, news of other pills specifically designed to make it easier for men to have erections started to appear in the popular press. The one that seems to have created the greatest buzz was a medication called Vasomax, a pill containing phentolamine. Urologists were very familiar with this medication, for they had been injecting phentolamine directly into the penis to stimulate erections in impotent men for years. When injected alone, phentolamine was only marginally effective in inducing erections, but like a gasoline additive, it did improve the efficiency and minimized noxious side effects of the more powerful penile erection medications. Used as a fusion “cocktail” — that is, a sprinkling of phentolamine, along with a dash of papaverine and a pinch of alprostadil — the combination known as Tri-Mix enjoyed some popularity as a kinder, gentler intrapenile injection regimen. It was alleged that bundling the three medications worked best, as Tri-Mix erections were more consistent and side effects less apparent than when either papaverine or alprostadil was used alone.

Like many other medications, phentolamine had been around for decades, approved by the FDA as a blood-pressure-lowering medication for both men and women whose high blood pressure was caused by a rare condition of an adrenaline-producing tumor of the adrenal gland called a pheochromocytoma (Pheo). Phentolamine can counteract the adrenaline effect by blunting propensity to cause blood vessels to narrow (constrict) and drive blood pressure up. Phentolamine allows vascular spaces to relax, dilate, or widen, specifically what is needed to allow blood to flow into the penile erectile chambers, and precisely what is needed to encourage the development of an erection.

Although business pages have been trumpeting the arrival of this new pill to treat impotence, which is said to be as effective “as Viagra, but with fewer side effects)” very little information has been available for scientists to analyze.

The first published report of the use of phentolamine pills to treat erectile dysfunction came in 1988. Dr. Grant Gwinup, who had some experience with phentolamine because he had used it to treat men and women with pheochromocytomas, learned that urologists had started using intrapenile phentolamine injections to stimulate an erection. Dr. Gwinup rounded up eight men with erectile dysfunction and gave them either placebo pills or phentolamine tablets to see if they had any improvement in their erections. He decided to give some men either placebo or phentolamine first and then in phase two reversed the order of pills. When placebo was given first, two of eight men had erections, whereas when phentolamine was first, erections occurred in five of eight men. Two men who did not have erections with phentolamine had erections with placebo. The results were so confusing that no further research with phentolamine pills was done for another decade.

Then, in April 1998, one month after the FDA approved Viagra, another article evaluating the effectiveness of oral phentolamine appeared. By this time phentolamine had a new name, Vasomax. This time forty impotent men had their erectile function evaluated after they took placebo pills or different doses of Vasomax.

The 20 percent of men who had erectile function restored after placebo is similar to the 24 percent of placebo responders in the earlier Viagra trials. However, unlike those studies that demonstrated 70-80 percent responses with escalating Viagra doses, no more than 50 percent of Vasomax-treated men had improved erectile function; and surprisingly, in this small study, an increasing dose was not associated with increased response. It is possible that larger studies may reveal increased effectiveness of Vasomax, but for the moment, the available data indicate that this medication is considerably less effective than Viagra.

One Response to “Vasomax”

  1. john says:

    i am interested to know if vasomax pills are in the market and if it increases arousal?

    thank you

Leave a Reply